Immunization Package (BI) Patch 12 Amy V

Immunization Package (BI) Patch 12 Amy V. Groom, MPH IHS Immunization Program Manager [email protected]

Overview of Changes in Patch 12

• New required fields in Roll and Scroll • Addition of new vaccine codes to Vaccine Table • Updates to vaccine names, look ups • A dult report • Pneumovax coverage • New adult composite measure • Forecasting fixes/changes • Re -forecasting of invalid Pneumo-PS doses for high risk patient • Meningococcal B vaccine forecasting

2 Adding Immunizations – New Required Fields

Note: Not yet required fields in EHR

3 New Vaccine Codes

• New Meningococcal Code - Mening, NOS (167) • Use if received meningococcal vaccine, but unknown if quadrivalent or Mening B or other meningococcal vaccine

• New Influenza code • FLU -IIV3ad (CVX code 168) • New adjuvanted trivalent influenza vaccine for 65 years and older for 2016- 17 season

4 Twinrix Display

• Change to Hep A component of Twinrix • N ow displays as Hep A PED (Twinrix)

5 Meningococcal Vaccines

6 Quadrivalent Meningococcal Vaccines • Protect against meningococcal strains A,C,W,Y • Conjugated vaccines • Routinely recommended for adolescents at 11-12, booster at 16 years • Menactra (Mening-CV4), CVX code 114 – Sanofi, diphtheria toxoid protein carrier • Menveo (MeningCV40), CVX Code 136– Novartis, conjugated to CRM

• Polysaccharide vaccine • Not recommended for routine use • Limited to patient older than 55 years indicated for meningococcal vaccine, or if conjugated vaccines not available • Menomune (MPSV4), CVX code 32- Sanofi

ACIP Quadrivalent Conjugate Meningococcal Vaccine Recommendations: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6003a3.htm

Meningococcal B Vaccines

• Protect against meningococcal strain B ONLY • NOT routinely recommended • Two vaccines • Trumenba - MenB-FHbp (Wyeth) – 3 doses • Bexsero - MenB-4C (Novartis) – 2 doses

ACIP Meningococcal B Vaccine recommendations: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6441a3.htm

8 Other Meningococcal Vaccines

• MenHibrix (Hib-MenCY-TT) – GSK • Com bination Hib (PRP-T ) and meningococcal vaccine for C/Y ONLY • Can be used in high risk children for whom meningococcal and Hib vaccines are indicated

• Meningococcal C vaccine – NOT AVAILABLE IN THE US • Protects against C strains only

9 Meningococcal Vaccines

• Men4, NOS (108) – use for quadrivalent meningococcal vaccine if unknown if conjugate or polysaccharide • MenCV4, NOS (147) – use for CONJUGATED quadrivalent meningococcal vaccine, but specific brand unknown (Menveo or Menactra) • Mening, NOS (167) – new code – use if received meningococcal vaccine, but unknown if quadrivalent or Mening B or other meningococcal vaccine

10 HPV Vaccine Names

11 Changes to Adult Report • Pneumovax coverage for adults 65 years and older now counts both PCV13 (CVX code 133) and Pneumo-PS (CVX code 33)

12 Adult Composite Measure

• Mirrors the current GPRA Adult Composite Developmental Measure Years Vaccines

19 – 59 years • Td-containing vaccine in the last 10 years AND • Tdap ever 60 – 64 years • Td -containing vaccine in the last 10 years AND • Tdap ever AND • Zoster 65 years + • Td -containing vaccine in the last 10 years AND • Tdap ever AND • Zoster AND • Pneumococcal vaccine (PPSV23 OR PCV13) on or after age 65 years or in last 5 years Overall Proportion of all adults 19 years and older who received the vaccines they SHOULD

have received for the age (as outlined above) 13 Adult Report – Composite Measure

14 Adult Composite Measure, cont.

15 Forecasting

• Fix to invalid PPSV23 given before age 65 years • Invalid dose is now re-forecast • New TCH forecaster – Version 3.12.03 • Meningococcal B forecasting

16 What Version of the TCH Forecaster do we have?

17 Report Text/Profile

18 Meningococcal B Vaccine • Recommended in June 2015 • NOT a routine recommendation • Category B – clinicians should CONSIDER • Recommended age: 16-18 years • Minimum age: 10 years • Maximum age: 23 years • Two vaccines – Not interchangeable • Trumenba - MenB-FHbp (Wyeth) – 3 doses • Bexsero - MenB-4C (Novartis) – 2 doses • Forecasting in RPMS: • First dose is not forecast for any patient • If patient receives first dose, then subsequent doses will forecast based on ACIP recommendations • Forecast will specify brand when appropriate • If either brand can be given system will forecast Men-B, NOS

ACIP Meningococcal B Vaccine recommendations: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6441a3.htm

Information About Updates to EHR Reminders

• Add FLU-IIV3ad (CVX code 168) to the EHR Reminder term IHS- INFLUENZA 2013 • There currently is not an EHR Reminder for the Meningococcal B vaccine. Meningococcal B vaccine is a DIFFERENT vaccine than the quadrivalent meningococcal vaccine. Do NOT add the new meningococcal B vaccines (CVX codes 162 [Men-B, Trmb], 163 [Men- B, Bex] and 164 [Men-B, NOS]) to the current EHR Reminder Term IHS-MENINGITIS. • The new Mening, NOS code (CVX code 167) is not specific to either meningococcal vaccine. Do NOT add this code to the current EHR Reminder Term IHS-MENINGITIS

20 Reminder Tab – Patient View

21 Resources

• RPMS Software Applications and Notes: https://www.ihs.gov/rpms/index.cfm?module=Applications&option=View &AC_ID=0

• TCH Forecaster Installation Instructions Addendum: https://www.ihs.gov/RPMS/index.cfm?module=Applications&option=View &AC_ID=0 • Click the Immunization Tracking System (BI) link. • Select the TCH Forecaster Installation Instructions Addendum listed under Supporting Documentation.

• Details on the TCH version 3.12.03 updates and version history: http://tchforecasttester.org/releaseNotes.html